PSA Surge With Abiraterone Has No Long-Term Impact on Outcome

Spike in PSA level after starting abiraterone does not affect progression-free or overall survival, study finds.

Men with castration-resistant prostate cancer (CRPC) treated with abiraterone may experience PSA surge, but it has no long-term impact on outcome, according to Italian investigators.

In a retrospective study of 330 CRPC patients (median age 74 years) being treated with abiraterone, Vincenza Conteduca, MD, PhD, of Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy, and colleagues monitored PSA levels at baseline every 4 weeks. They defined PSA surge as a PSA increase within the first 8 weeks from the start of abiraterone therapy of more than 1% from baseline followed by a PSA decline.

The cohort included 281 patients previously treated with chemotherapy and 49 chemotherapy-naïve patients.

The investigators identified PSA surge in 20 (7%) chemotherapy patients and 2 (4%) chemotherapy-naïve patients (4%), Dr Conteduca's team reported online ahead of print in The Prostate. For the patients experiencing PSA surge, the timing of PSA peak from baseline was a median of 5 weeks; the median PSA rise from baseline was 21%.

During an overall median follow-up was 23 months, the investigators observed no significant differences in progression-free and overall survival between the patients with and without PSA surge.